The use of smart watch technology to improve the management of patients presenting with fast irregular heart rates in the Emergency department - a pilot study

Recruit 50 participants (Intervention group) with atrial fibrillation (AF) where the onset is less than 24 hours before presentation to emergency department (ED), who are able to have delayed cardioversion in addition to standard medical care. These participants will receive at home monitoring of their heart rhythm with the Alivecor mobile single lead electrocardiogram (ECG) device. The participants will be required to record and transmit each single lead ECG every 6 hours for 48 hours. Participants will receive a text message and/ or phone call if a ECG recording is missing. If normal rhythm is restored spontaneously within 48 hours, they will not be required to return to ED. The minority (31%) of participants with ongoing AF will be instructed to return to ED for a scheduled cardioversion. In both scenarios, after the initial 48 hour period, the patient will be asked to record and send ECGs twice weekly, which will be reviewed by the research team. Four weeks later, they will have a follow-up cardiology appointment, either in person or via telemedicine.